Provider Demographics
NPI:1528270105
Name:TRESCOTT, JEAN LOUISE (PHD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:LOUISE
Last Name:TRESCOTT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 S NORTHLAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-1315
Mailing Address - Country:US
Mailing Address - Phone:305-772-0924
Mailing Address - Fax:954-920-0951
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:SUITE 360
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-772-0924
Practice Address - Fax:954-920-0951
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4780103TA0700X, 103TB0200X, 103TC0700X, 103TF0000X, 103TH0004X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy